Identification of 4th intercostal space using sternal notch to xiphoid length for accurate electrocardiogram lead placement

Kevin Day, Isabel Oliva, Elizabeth A Krupinski, Frank Marcus

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Objective Precordial ECG lead placement is difficult in obese patients with increased chest wall soft tissues due to inaccurate palpation of the intercostal spaces. We investigated whether the length of the sternum (distance between the sternal notch and xiphoid process) can accurately predict the location of the 4th intercostal space, which is the traditional location for V1 lead position. Materials and Methods Fifty-five consecutive adult chest computed tomography examinations were reviewed for measurements. Results The sternal notch to right 4th intercostal space distance was 67% of the sternal notch to xiphoid process length with an overall correlation of r = 0.600 (p <0.001). Conclusion The above measurement may be utilized to locate the 4th intercostal space for accurate placement of the precordial electrodes in adults in whom the 4th intercostal space cannot be found by physical exam.

Original languageEnglish (US)
Pages (from-to)1058-1061
Number of pages4
JournalJournal of Electrocardiology
Volume48
Issue number6
DOIs
StatePublished - 2015

Keywords

  • ECG lead placement
  • Imaging
  • Intercostal space
  • Sternal notch

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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